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Cardiac Anomalies - is something going on or is this normal?

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Re: Cardiac Anomalies - is something going on or is this nor

Nomad said:
simoni said:
samhocking said:
I don't see the heart anomalies as that abnormal. I know of 3 riders in my local area out of perhaps 200 who I would argue raced too hard, train too much and love cycling on the limit so much, it has left them with various heart issues requiring surgery.
Always important to remember, humans are designed to walk, climb, run, jump, crawl, lift, swim and have sex in short intervals of several minutes. Riding a bike for 5 hours every day for 3 weeks is as unnatural as sitting stationary in front of a TV eating chips for 5 hours a day for 3 weeks or running a marathon everyday for 3 weeks. All, we are not designed to do well.
Dunno, there's a fairly significant body of thought that we are designed for long distance running, basically to hunt for food. We are endurance machines.

Obviously this is a bit different to riding a bike hard. My impression, after doing a lot of both, is that you can put yourself in a much greater level of "general" fatigue on a bike because when running the muscles in your legs tend to get too damaged to work properly before other constraints kick in. I ran just inside 2:30 for a marathon and was in a mess for weeks yet am capable of putting in similar length hard efforts on a bike day after day. Does it follow that this would put more pressure on the heart/lungs over a long period?
You're absolutely right - our bodies are designed for long-distance running & walking. In fact, we are the only mammals that have the physiology for efficient endurance capabilities over very long distances.

https://news.harvard.edu/gazette/story/2007/04/humans-hot-sweaty-natural-born-runners/

http://www.slate.com/articles/health_and_science/new_scientist/2013/06/daniel_lieberman_long_distance_running_we_evolved_endurance_and_dislike.html
We definitely are not designed for long distance running over multiple days. Clearly we are designed to run short distances like those articles state of 10-15km (1-2000 calories) on single day, because that's how much energy we can store without stopping and refuelling, but not 5 hours a day everyday for 3 weeks. If that was required to hunt food you would be burning 6-7000 calories a day chasing antelope and not even be able to eat 7000 calories from that antelope in time for the next days running. You would be burning 7000 calories a day to eat 7000 calories a day which is pointless when you only need 2000.
 
For fans of join the dots: Dutch media investigation claims legal thyroid meds - which bring increased risk of heart problems + sudden death - being used in multiple sports and multiple countries to aid weight loss:
Top athletes would use the medication in particular because they think it causes weight loss. [...] The seriousness appears from a letter (.pdf) of 10 July of the Dutch skating union (KNSB) to the skaters. "The KNSB stands for a clean, fair and therefore doping-free sport," writes technical director Remy de Wit. "Recently we have received signals that athletes in the skating world are prescribed medication that, although not on WADA's doping list, but whose use without medical necessity poses health risks, we would like to warn you specifically." [...] A letter (.pdf) from the Doping Authority was also sent to WADA on 10 July, which was also signed by sports organization NOC*NSF and the Ministry of Health, Welfare and Sport. It is requested to place thyroid hormones on the banned list. "We have indications from medical professionals in the Netherlands that thyroid hormones are currently being abused by top athletes," he says.[...] "There is an increased risk of osteoporosis, heart problems and sudden death", says Visser when it comes to misuse (abuse) of thyroid hormones.
 
Re:

fmk_RoI said:
A recent article in Le Monde (€) claimed there is evidence thyroid meds are being used in cycling and the UCI is conscious of this. If anyone has accessed this and think it adds anything, please post a quote/summary. TIA.
The intro to the article is about the abnormal weight loss phenomenon in cycling, and uses Wiggins as an example of a "human guinea pig" for some kind of new methods, and says Froome "looks like a concentration camp victim". So then, there's a rundown of possible methods of extreme weight loss while maintaining or increasing power. With hormones thyroïdiennes being one of them.
- Le directeur médical de l’UCI, Xavier Bigard, s’inquiète des « moyens mis en œuvre pour arriver à ces états » (anorexiques), citant, comme les médecins d’équipe, la prise d’hormones thyroïdiennes (T3 et T4). Normalement prescrites à des patients souffrant d’insuffisances de la glande thyroïde, ces gélules en vente libre sur Internet facilitent l’élimination des graisses et sont utilisées dans plusieurs équipes, malgré les risques de dérèglements hormonaux.
"The medical director of the UCI is worried about these "techniques which have been put into use to arrive at these anorexic states", citing, as do team doctors, the thyroid hormones T3 and T4. Normally prescribed for patients suffering from thyroid insufficiency, capsules [of T3/T4] sold openly on the internet assist in fat reduction, and are used by several teams, despite the risks of hormonal disturbances."
Elles ne sont pas interdites par le code mondial antidopage, mais l’UCI réfléchit à un « contrôle et à la régulation de l’utilisation de ces extraits hormonaux », révèle le professeur. « Les extraits thyroïdiens sont hyperdangereux et inconcevables, tranche Jacky Maillot, médecin de l’équipe Groupama-FDJ. Ça devrait être interdit puisque c’est du dopage masqué. »
"These are not prohibited by the WADA code but the UCI is considering "testing and regulation of these hormonal extracts", the professor reveals. "Thyroid extracts are super-dangerous and inconceivable", opines Jack Maillot, team doctor for Groupama-FDJ. "They should be banned because they are a form of hidden doping"

What does this article add to the discussion, well the reasons cyclists might take thyroid hormones are: definitely for the metabolic effect of losing fat, and possibly for the endocrine effect of small increases in endogenous EPO. The endocrinology is complicated, but raising EPO is a possible ancillary motive. And furthermore, it's a matter of fact that this grey-area use of thyroid hormones has been used in elite running by athletes such as Mo Farah, and that thyroid medicines are part of Salazar's training regimen
https://www.nytimes.com/2017/05/19/sports/nike-oregon-project-alberto-salazar-dathan-ritzenhein.html

And what the Le Monde interview quotes add to that is: apparently it is also a matter of fact that "several" WT or pro conti cycling teams are using T3/T4.
 
Re:

fmk_RoI said:
A death (age: 23) and a retirement (age: 20)
I don't know what to say, other than sadness and "what-if" wondering, if they had not pursued pro cycling then maybe the one of them would still be alive today, and now the other may have caused himself future heart trouble

About the thyroid hormones I put that above, and yes, the number-one reason for cyclists not to tinker with this grey-area thyroid-function doping is, that it can cause atrial fibrillation. Dangerous for heart rhythm
 
What really scares me is how random it seems to be whether anything is detected or not.
Tanguy Turgis dodged the bullet, but then there's Jimmy Duquennoy; nothing detected in the pre-season tests, seemed fine, and then… just... gone!
 
Mar 24, 2015
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4 young Belgian riders to suddenly die of cardiac arrest in the last year.
Three of them at home. Vanacker and Goeleven while sleeping.

Bjarne Vanacker (20) - Nov 2017
Jeroen Goeleven (25) - Aprl 2018
Michael Goolaerts (23) - April 2018
Jimmy Duquennoy (23) - Oct 2018

Do you know of anyone from other nationalities that died in the same period? I don't.

It looks more than a coincidence to me.
 
Re:

huge said:
4 young Belgian riders to suddenly die of cardiac arrest in the last year.
Three of them at home. Vanacker and Goeleven while sleeping.

Bjarne Vanacker (20) - Nov 2017
Jeroen Goeleven (25) - Aprl 2018
Michael Goolaerts (23) - April 2018
Jimmy Duquennoy (23) - Oct 2018

Do you know of anyone from other nationalities that died in the same period? I don't.

It looks more than a coincidence to me.
Nietzsche. “That which does not kill us, makes us stronger.”
us = belgium national squad
 
Re: Re:

ClassicomanoLuigi said:
fmk_RoI said:
A recent article in Le Monde (€) claimed there is evidence thyroid meds are being used in cycling and the UCI is conscious of this. If anyone has accessed this and think it adds anything, please post a quote/summary. TIA.
The intro to the article is about the abnormal weight loss phenomenon in cycling, and uses Wiggins as an example of a "human guinea pig" for some kind of new methods, and says Froome "looks like a concentration camp victim". So then, there's a rundown of possible methods of extreme weight loss while maintaining or increasing power. With hormones thyroïdiennes being one of them.
- Le directeur médical de l’UCI, Xavier Bigard, s’inquiète des « moyens mis en œuvre pour arriver à ces états » (anorexiques), citant, comme les médecins d’équipe, la prise d’hormones thyroïdiennes (T3 et T4). Normalement prescrites à des patients souffrant d’insuffisances de la glande thyroïde, ces gélules en vente libre sur Internet facilitent l’élimination des graisses et sont utilisées dans plusieurs équipes, malgré les risques de dérèglements hormonaux.
"The medical director of the UCI is worried about these "techniques which have been put into use to arrive at these anorexic states", citing, as do team doctors, the thyroid hormones T3 and T4. Normally prescribed for patients suffering from thyroid insufficiency, capsules [of T3/T4] sold openly on the internet assist in fat reduction, and are used by several teams, despite the risks of hormonal disturbances."
Elles ne sont pas interdites par le code mondial antidopage, mais l’UCI réfléchit à un « contrôle et à la régulation de l’utilisation de ces extraits hormonaux », révèle le professeur. « Les extraits thyroïdiens sont hyperdangereux et inconcevables, tranche Jacky Maillot, médecin de l’équipe Groupama-FDJ. Ça devrait être interdit puisque c’est du dopage masqué. »
"These are not prohibited by the WADA code but the UCI is considering "testing and regulation of these hormonal extracts", the professor reveals. "Thyroid extracts are super-dangerous and inconceivable", opines Jack Maillot, team doctor for Groupama-FDJ. "They should be banned because they are a form of hidden doping"

What does this article add to the discussion, well the reasons cyclists might take thyroid hormones are: definitely for the metabolic effect of losing fat, and possibly for the endocrine effect of small increases in endogenous EPO. The endocrinology is complicated, but raising EPO is a possible ancillary motive. And furthermore, it's a matter of fact that this grey-area use of thyroid hormones has been used in elite running by athletes such as Mo Farah, and that thyroid medicines are part of Salazar's training regimen
https://www.nytimes.com/2017/05/19/sports/nike-oregon-project-alberto-salazar-dathan-ritzenhein.html

And what the Le Monde interview quotes add to that is: apparently it is also a matter of fact that "several" WT or pro conti cycling teams are using T3/T4.
Thanks for doing the summary/translation job.
 
Re:

huge said:
4 young Belgian riders to suddenly die of cardiac arrest in the last year.
Three of them at home. Vanacker and Goeleven while sleeping.

Bjarne Vanacker (20) - Nov 2017
Jeroen Goeleven (25) - Aprl 2018
Michael Goolaerts (23) - April 2018
Jimmy Duquennoy (23) - Oct 2018

Do you know of anyone from other nationalities that died in the same period? I don't.

It looks more than a coincidence to me.
Did you read the OP? Did you read any of the thread?

The fact that you include Bjarne Vanaker in your little listicle suggests you are seeking confirmation of a theory. If you'd bothered to read the OP you'd see he's not the only amateur we know has died. We know of the Egyptian rider, Nasser. We know of the British rider, Craig. Are they the only amateurs to have died? Unlikely. Most amateur deaths wouldn't even make the local papers, let alone international news. Which is partly why there has been an attempt to restrict the debate to elite level pros.
 
With so much interest in an apparent Belgian nexus here I'm surprised nobody's bothered to point out that Jimmy Duquennoy, the most recent death, was since 2017 a team-mate of Grégory Habeaux, who retired earlier this year as a result of a cardiac condition. Three deaths in a year and something in a country with a population of eleven million is one thing, two cardiac cases in a matter of months in a team of nineteen is something else entirely.
 
Re:

RedheadDane said:
What really scares me is how random it seems to be whether anything is detected or not.
Tanguy Turgis dodged the bullet, but then there's Jimmy Duquennoy; nothing detected in the pre-season tests, seemed fine, and then… just... gone!
Well, SADS is random. We don't come with use-by dates stamped on our sternums.
 
Re:

King Boonen said:
This thread started with such good intentions...
This thread started with the intention of trying to add perspective to a complicated issue. Fifteen months in, has this thread achieved anything? Consider the reality.

Each time one of these cases arises, be it a death or a retirement, we get a few names the journalist reporting the story remembers, nothing more, an incomplete and often misleading picture of reality.

Each time one of these cases arises, be it a death or a retirement, we get leaps between the World Tour (pop: c500 riders), pro conti and conti (pop: several thousand riders), track (pop: large), cross (pop: higher than you think), and even amateur levels (pop: vast). What seems unusual in a group of 500 riders doesn't always look unusual in a group of 10,000+ riders.

Each time one of these cases arises, be it a death or a retirement, we get next to no perspective on the real world incidence of such events, or even the incidence of such events in other sports. We know that SADS is real and we know that not all heart conditions can be spotted, no matter how much screening is put in place, so we know that we should expect some deaths and retirements. We just don't know how many.

Each time one of these cases arises, be it a death or a retirement, we get the usual leaping to conclusions that doping has to be involved. We've been through the problem of blaming doping: there's not enough cases for that to be true every time and if the argument is pushed we'll end up proving there is no doping and have to close the Clinic down.

Can doping be used to explain any of these cases? Maybe. The thyroid stories suggest there is genuine concern in some quarters about a particular problem, a problem thought to impact cycling. There was also genuine concern about the alleged EPO deaths in the early 1990s - even if not a single death in pro cycling has ever been ascribed to EPO - sufficient concern for the UCI to investigate the matter. There seems to be some evidence that the UCI is not unaware of the level of cardiac cases in cycling. But there doesn't seem to be a desire to talk publicly about the issue. So, while the UCI is now acting on the drugs we were complaining about three, four, five years ago, it may be only after Tim Kay's new Global Cycling Project has put a Chinese cyclist on the top step of the Tour's podium in 2025 that we'll see action from the UCI on thryroid meds. But can thyroid meds explain what we are actually seeing? I doubt it: it is at WT level that weight seems to be the biggest concern and yet here we are, nine months through 2018 and I don't think there's been a single cardiac case at WT level, which I don't think has happened since 2013.

Fifteen months in, has this thread achieved anything? No. People still see only what people want to see. People don't really want real evidence.
 
Apr 23, 2016
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5
2,845
Re: Re:

fmk_RoI said:
King Boonen said:
This thread started with such good intentions...
This thread started with the intention of trying to add perspective to a complicated issue. Fifteen months in, has this thread achieved anything? Consider the reality.

Each time one of these cases arises, be it a death or a retirement, we get a few names the journalist reporting the story remembers, nothing more, an incomplete and often misleading picture of reality.

Each time one of these cases arises, be it a death or a retirement, we get leaps between the World Tour (pop: c500 riders), pro conti and conti (pop: several thousand riders), track (pop: large), cross (pop: higher than you think), and even amateur levels (pop: vast). What seems unusual in a group of 500 riders doesn't always look unusual in a group of 10,000+ riders.

Each time one of these cases arises, be it a death or a retirement, we get next to no perspective on the real world incidence of such events, or even the incidence of such events in other sports. We know that SADS is real and we know that not all heart conditions can be spotted, no matter how much screening is put in place, so we know that we should expect some deaths and retirements. We just don't know how many.

Each time one of these cases arises, be it a death or a retirement, we get the usual leaping to conclusions that doping has to be involved. We've been through the problem of blaming doping: there's not enough cases for that to be true every time and if the argument is pushed we'll end up proving there is no doping and have to close the Clinic down.

Can doping be used to explain any of these cases? Maybe. The thyroid stories suggest there is genuine concern in some quarters about a particular problem, a problem thought to impact cycling. There was also genuine concern about the alleged EPO deaths in the early 1990s - even if not a single death in pro cycling has ever been ascribed to EPO - sufficient concern for the UCI to investigate the matter. There seems to be some evidence that the UCI is not unaware of the level of cardiac cases in cycling. But there doesn't seem to be a desire to talk publicly about the issue. So, while the UCI is now acting on the drugs we were complaining about three, four, five years ago, it may be only after Tim Kay's new Global Cycling Project has put a Chinese cyclist on the top step of the Tour's podium in 2025 that we'll see action from the UCI on thryroid meds. But can thyroid meds explain what we are actually seeing? I doubt it: it is at WT level that weight seems to be the biggest concern and yet here we are, nine months through 2018 and I don't think there's been a single cardiac case at WT level, which I don't think has happened since 2013.

Fifteen months in, has this thread achieved anything? No. People still see only what people want to see. People don't really want real evidence.
Cardiologists make the best doctors for endurance sports.
 
This article is about Freds and what happens with Freds doesn't really compare to what happens at the elite level of sport. But it does highlight the need for screening - which cycling does have, but could improve upon - and also the limits of screening.

Every week 12 young people die from sudden cardiac death. Is it time to start screening runners?
SCD in the young is a tragic and shocking phenomenon, which kills around 12 people aged 35 and under every week in the UK. An estimated one in 300 of the general population has an underlying heart condition predisposing them to SCD. With more than ten million people in Europe taking part in endurance sports such as marathons and iron man competitions, it is inevitable that we will hear the news of another young and fit person dying while participating in one of these events. In the younger population, SCD occurs due to structural heart disease, cardiomyopathy, or electrical disturbances of the heart. In older people, the risk is mainly due to coronary artery disease (heart attacks). Up to 80 per cent of SCD occurs in people who were previously free of any symptoms.
While screening works, it has its limits:
Research shows that mandatory screening of all young people in Italy who participated in sport led to an 89 per cent reduction in SCD.
Taking the number given for British deaths - 12 a week - were the UK to introduce screening of Freds and have the same success the Italians had, the death toll could fall to four every three weeks.

For perspective on the headline number: 12 a week is about 625 a year. About 44% of the UK population is aged below 35, so that's about 625 deaths out of about 29 million people, which is 0.002%, give or take.
 
Cyclists to have heart scans amid cardiac arrest fears

The screening at British Cycling is being carried out and paid for by a team from Liverpool John Moores University as part of their research into cardiac health among athletic people.

Professor John Somauroo, a sport and exercise cardiologist, said: "We know there are high profile athletes having cardiac arrests.

"But equally unfortunately there are about current thinking around 12 young athletes between the ages of 14 and 35 per week dropping dead in Britain.

"And in fact that's relatively old data and the newer data suggests that it's at least 20 young people if not even higher that are having those events per week."

He added: "If you were to have a bus load of kids crashing into a low bridge every week and half the children were killed.

"They'd do something about the bridges or the bus routes."
report
 
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